OTC pain relievers

 I take Advil about four times a week for the pain I get in my legs from sustained exercise (golf, house cleaning, yardwork.) Advil definitely helps, but I’ve discovered that it’s probably implicated in my occasional bouts of acid reflux—a new thing for me. So I’m looking at alternative over-the-counter pain relievers. Here are the common ones:

Non-steroidal anti-inflammatory drugs (NSAIDS): Because these drugs work by blocking certain enzymes (COX-1 and COX-2) that are involved in the inflammatory process, they impede inflammation and the pain it can cause. They work outside the central nervous system and at the site of tissue damage. All are better than Tylenol (acetaminophen) for inflammatory injury or disease.

•  Advil, Midol (ibuprofen): best for quick action; better than Aleve for acute pain; because it is short acting, it must be taken more often than Aleve; it can cause damage to the stomach and intestines and can cause heartburn.
•  Aleve (naproxen): lasts longer than Advil; better than Tylenol for pain involving inflammation; associated with fewer side effects than Advil, although has a higher risk of stomach ulcers.
• Aspirin: as good as other NSAIDs for pain relief (and is cheaper). However, it’s more of an irritant to the stomach and can cause bleeding.

With the exception of aspirin, the risks of overdoing NSAIDS include an increased risk of heart attack or stroke. This risk is actually quite small, but increases with chronic usage, higher doses, and for people with known cardiovascular disease.

 Tylenol (acetaminophen): This drug works inside the central nervous system, has fewer side effects than other OTC pain medications and doesn’t interact negatively with most common drugs. However, it doesn’t reduce inflammation. Scientists don’t know exactly how it works. One theory is that it uses the same communication systems in the brain as those used by opioids such as morphine. When over-used Tylenol can damage the liver, especially if combined with alcohol.

The last time I walked the golf course, I tried taking Aleve instead of Advil. It didn't do much good (I have a torn meniscus, sciatica, and bursitis). I'll try aspirin next, but am not very hopeful. I'll probably have to stick with Advil, but will use it only twice a week instead of four times. I'll just suffer through house cleaning and yard work. Or maybe aspirin will work.

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